Loek Habbema, M.D.
Medisch Centrum ‘t Gooi
Olmenlaan 42, NL-1404 DG Bussum
loek(at)mcgooi.nl

Background: Lipedema is a chronic, progressive, congenital disease, affecting the subcutaneous fat tissue of the legs and arms in females. Clinical signs of the disease range from mild to severe. Conservative and surgical treatment need a specific approach. Differentiation from, or combination with lymfedema is important regarding the treatment plan..
Methods: Patients with lipedema are diagnosed as such during consultation based on the history and clinical presentation. After adequate selection, patients are treated by conservative treatment and Liposuction using Super Tumescent Local Anesthesia (STLA) and Powered Cannulas (PC). Limited areas are treated generously using supertumescence by slow infiltrating up to 14.000 mL of Tumescent Solution. Circumferential treatment in one (lower leg) or multiple (upper leg) sessions is performed.
Results: Removal of the lipedematous fat with respecting the subcutaneous fibrous network leads to reduced mechanical obstructions. Mobility of the patient improves, resulting in more physical activity and muscle strength improvement. Also pain tiredness disappears or improves. Social life gains quality.. By removing the maximum amount of fat that is allowed by the safety guidelines, excellent long-term results are to be expected and the maximal effect on pain reduction and improvement of mobility is reached.
Conclusion: Lipedema is a serious, progressive, congenital disease with a high incidence, affecting almost exclusively women. Liposuction using and PC is a safe and effective treatment modality. After circumferential treatment in multiple sessions, pain, mobility and quality of life is improved. Medical professionals should recognize the disease and offer this technique.

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